| NPI | 1376069229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA LAURIE PURDUM Owner 702-932-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Z00000X Orthotist (Licence: NV C52329) |
| Additional Taxonomies | 224P00000X Prosthetist (Licence: NV C52329) |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2022-07-21 |